Isolated tuberculosis of the greater trochanter: a case report
Halil Yalçın Yüksel1, Ertuğrul Akşahin1, Levent Çelebi2, Hasan Hilmi Muratlı2, Ali Biçimoğlu2
1Department (3rd) of Orthopedics and Traumatology, Ankara Numune Education and Research Hospital
2Department (3rd) of Orthopedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara
Keywords: Antitubercular agents/therapeutic use; bursitis; debridement; femur/pathology/radiography; hip joint; magnetic resonance imaging; tuberculosis, osteoarticular/therapy.
Abstract
Isolated tuberculosis of the greater trochanter is an extremely rare entity. A 67-year-old man presented with a two-month history of drainage from his left hip, about 4 cm below the trochanteric region. He reported a history of swelling over the left greater trochanteric region, that appeared following a minor trauma three years before. Neither the patient nor his family members had tuberculosis previously. On physical examination, there was a fistula about 4 cm distal to the trochanteric region. A plain radiogram of the left hip and femur showed a massive osteolytic lesion involving the greater trochanter and multiple radiopacities in the soft tissue. Magnetic resonance imaging revealed bursitis of the greater trochanter with extension and erosion to the bone and soft tissue abscesses in the anterior and lateral aspects of the femur. Curettage of the surface of the greater trochanter and complete excision of calcific and necrotic lesions were performed. The diagnosis of tuberculosis was confirmed by pathologic examination, positive cultures, and positive microscopic staining for acid-resistant bacilli. The patient received antituberculosis therapy for 12 months, after which complete remission was obtained.